10 Deadliest Drugs

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PharmDstudent

PharmDstudent

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What do you think about this list?

Rank ___Drug ______________Type _________________________________________Deaths (1998-2005)
1 ______Oxycodone__________Prescription opioid painkiller* ______________________5548
2 ______Fentanyl ___________Prescription opioid painkiller* ______________________3545
3 ______Clozapine __________Antipsychotic ___________________________________3277
4 ______Morphine ___________Prescription opioid painkiller* ______________________1616
5 ______Acetaminophen ______Over-the-counter painkiller _______________________1393
6 ______Methadone _________Prescription opioid painkiller*/addiction medication _____1258
7 ______Infliximab___________Immune-system modulating drug____________________1228
8 ______Interferon beta______Immune-system modulating drug____________________1178
9 ______Risperidone_________Antipsychotic____________________________________1093
10______Etanercept_________Immune-system modulating drug____________________1034
(10 Deadliest Drugs article)

Would you have thought that something else would be deadlier?
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Another stupid media piece of crap.

Many of these are only "deadly" due to stupidity. Opiods are safe. If you take 20 times the normal dose of any drug, it will kill you. It shouldn't be a shock that the most abused strong opioid are "deadly". I have a feeling it's the same with acetaminophen. If you've spent any time in an ED, you're seen a blue billion idiots try to ingest an entire bottle of Tylenol and commit suicide.

Now the immunomodulators and clozapine are legit being as though agranulocytosis is going to happen occasionally with both. Though ever since mandatory CBCs for patients, clozapine deaths have declined.

Screw the media though. A bunch of damned sensationalist idiots they are. They last thing we need are schizophrenic people afraid to take their clozapine for their refractory psychosis because it'll kill them. :rolleyes:
 
WVUPharm2007 said:
Another stupid media piece of crap.

Many of these are only "deadly" due to stupidity. Opiods are safe. If you take 20 times the normal dose of any drug, it will kill you. It shouldn't be a shock that the most abused strong opioid are "deadly". I have a feeling it's the same with acetaminophen. If you've spent any time in an ED, you're seen a blue billion idiots try to ingest an entire bottle of Tylenol and commit suicide.

Now the immunomodulators and clozapine are legit being as though agranulocytosis is going to happen occasionally with both. Though ever since mandatory CBCs for patients, clozapine deaths have declined.

Screw the media though. A bunch of damned sensationalist idiots they are. They last thing we need are schizophrenic people afraid to take their clozapine for their refractory psychosis because it'll kill them. :rolleyes:
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Look at you Mikey! Making all kinds of sense lately. :p Couldn't agree more...

That's a huge pet-peeve of mind with the media.
 
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Indeed, well put WVU
 
I'm surprised not to see any TCAs on there. Again, an overdose, but a pretty good one.
 
they need to look at death per dose dispensed. Tylenol? Heck.... consider how many millions of tabs taken worldwide...

I bet Heparin and/or Lovenox will make the top 10.
 
I remember reading of someone dying from Xanax.

I have also heard of overdosing on stimulants on Ritalin.
 
Markovnikov said:
I remember reading of someone dying from Xanax.

I have also heard of overdosing on stimulants on Ritalin.
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I didn't think you could die from one benzo alone without alcohol or something else in your system. I wanna see colchicine on that list, 6mg (10 tabs) of that PO and you're dead.
 
coumadin? nsaids? if you lump aspirin and nsaids together that's gotta make the list. coumadin alone i thought would have made it.

clozaril is pretty high given the number of prescriptions i would think.

how is risperdal killing people?
 
radslooking said:
coumadin? nsaids? if you lump aspirin and nsaids together that's gotta make the list. coumadin alone i thought would have made it.

clozaril is pretty high given the number of prescriptions i would think.

how is risperdal killing people?
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I was shocked to not see Coumadin, that was my first guess, but my second was dig.

I'm guessing the Risperdal is through NMS, but I would've guessed Haldol way before that.

Oh, and this explains the opioids:

Furberg’s study did not distinguish between medical use and abuse of opioid painkillers, and other research has found that the overwhelming majority of deaths occur in drug addicts, not patients.
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:eek: Alert the ASMP! :rolleyes:
 
I agree with this, though:

The antipsychotics should only be taken if there are no other alternatives, as this class of medication can increase mortality risk overall.
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"Alternatives" is a weird way to put it, but I think even health care professionals would be shocked at the number of people with psychosis who manage it through psychotherapy alone, or have even just learned to live with it by themselves.
 
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RxWildcat said:
I didn't think you could die from one benzo alone without alcohol or something else in your system. I wanna see colchicine on that list, 6mg (10 tabs) of that PO and you're dead.
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Bumping a rather old thread, but, as of when I was in school, the only BZD that ever was associated with single-drug ingestion death was midazolam. Every other - bar none - had to be coingested with another substance, usually one of a depressant nature. Whereas the predicted dose of lethal single BZD diazepam is >5000mg (yep - 5mg PO x 1000 - imagine that - handfuls and handfuls and even more handfuls of pills, choking them all down - trying to do so before you fall asleep), as little as 50mg when taken with ETOH is associated with mortality.
 
This was why the benzos supplanted older sedative/hypnotics, the meprobamate, barbiturates, chloral hydrate, etc: they're actually safe in OD if taken by themselves, and if your pt isn't elderly and has respiratory compromise.

And yes; it's true that addicts make up most of the ODs. But as I've said before, there's the complicity of the health care system in creating these addicts in the 1st place.
 
Statistically, the deadliest drugs are probably insulin, coumadin, TCA's and NSAIDS. Not that many people die of opioid overdose anymore (percentage-wise) but a HUGE number of people on those 4 end up in the ER at some point and there are a ton of deaths caused by them.
 
"Furberg's study did not distinguish between medical use and abuse of opioid painkillers, and other research has found that the overwhelming majority of deaths occur in drug addicts, not patients. In addition, most deaths related to opioid painkillers involve taking a combination of four of five other drugs, which makes them seem more deadly than they are."

Duh...


And the study they cited only looked at the adverse event reports to the FDA. I'm sure you all know how accurate that is... :-/
 
FruitFly said:
I'm actually surprised by this one...
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You are surprised with etanercept at #10, but not infliximab at #7???? Doesn't make sense to me. However, perhaps you have not seen Fusarium grow out of someone's eye socket due to immune system ablation.....errr, modulation.
 
How often do you hear of people dying from antimicrobials?
 
Why not warfarin?

I guess people are careful enough with it that it doesn't kill people...but it has the potential of being quite deadly.
 
This list would be better served by measuring mortality per dose given.

That will show what drugs are truly dangerous.

10 deaths in 3 billion doses vs. 10 deaths in 10,000 doses...
 
Sparda29 said:
Amphoterecin, vancomycin (well not that many people prescribed this), penicillin (severe allergic reaction)

Not an antibiotic, but what about digoxin?
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You're kidding, right? Everyone and their mother is on vancomycin.

As far as toxicity of ampho and vanco, they have pretty well defined therapeutic limits that can aid in preventing that toxicity from being reached. Not to mention that amphotericin isn't really all that common to see anymore, with the broader-spectrum azoles and echinocandins (an exception being my hospital evidently, but that's another story).

A true anaphylactic reaction to penicillin is also not all that common...it's mostly less severe allergies that you'll see.

Digoxin has lost its popularity recently, and as it is used largely for the treatment of heart failure, it's hard to say whether it was the drug or disease process that ultimately did the patient in.
 
I see a lot of people on ampho, but then again we have a lot of immunocompromised patients. We also have both caspo and micafungin.

then there are the antimitotic agents.... now those are toxic mofos
 
Sparda29 said:
Vancomycin
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Not a killer... except maybe when you have a bug resistant to it (bad MRSA?) and no one is paying attention to the CBC or trough levels.

And truth be told... medication errors kill people.

Running a story about the deaths that occur when people take the correct med is more interesting - but it isn't NEARLY as common as someone getting the wrong med and dying.
 
I'm not too surprised about acetaminophen. OTC drugs aren't exactly monitored so it's pretty easy to abuse them. In high school, a friend of mine took some at any signs of pain, usually different brands/generics to treat "different" types of pain like headaches, muscle aches, etc.
 
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